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A Histopathologic Study of 24 Cases

Constantin E. Orfanos, MD; Gundula Schaumburg-Lever, MD; Walter F. Lever, MD

Arch Dermatol. 1974;109(5):682-688.

Abstract
Light and electron microscopical studies of erythema multiforme showed two types of tissue changes with the bullae forming at a different location in each type. (a) Erythematous papular lesions revealed primarily dermal edema resulting in intradermal bulla formation, with the basal lamina at the top of the blister. (b) "Target" lesions showed primarily epidermal damage resulting in bulla formation at the dermal-epidermal junction, with the basal lamina, if preserved, at the floor of the bulla. Vascular changes were encountered in both types. These findings show that analogous to the multiform clinical appearance of erythema multiforme, the type of bulla that develops in a given case depends on whether the dermis or the epidermis is primarily involved.

Author Affiliations
Cologne, West Germany; Boston

From the departments of dermatology, University of Cologne, West Germany (Dr. Orfanos); and Tufts University School of Medicine, Boston (Drs. Schaumburg-Lever and Lever).

Footnotes
Accepted for publication Aug 21, 1973.

Read in part before the 13th International Congress of Dermatology, Venice, Italy, May 22, 1972.

Reprint requests to Department of Dermatology, University of Cologne, Köln-Lindenthal, West Germany (Prof Orfanos).

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